Public Place Smoke-Free Regulations, Secondhand Smoke Exposure and Related Beliefs, Awareness, Attitudes, and Practices among Chinese Urban Residents
Abstract
:1. Introduction
2. Methods
2.1. Setting
2.2. Study Design
2.3. Sampling and Sample
2.4. Methods of Data Collection
2.5. Measures
N (%) | HZ (Time 1) | HZ (Time 2) | JX (Time 1) | JX (Time 2) | p-value * | ||
---|---|---|---|---|---|---|---|
n (%) | n (%) | n (%) | n (%) | ||||
Total | 2,867 | 800 | 669 | 740 | 658 | ||
Age (years) | |||||||
<25 | 226 (7.9) | 34 (4.3) | 62 (9.3) | 64 (8.7) | 66 (10.0) | 0.328 | |
25- | 666 (23.2) | 195 (24.4) | 152 (22.7) | 151 (20.4) | 168 (25.5) | ||
35- | 620 (21.6) | 156 (19.5) | 134 (20.0) | 160 (21.6) | 170 (25.8) | ||
45- | 489 (17.1) | 170 (21.2) | 128 (19.1) | 90 (12.2) | 101 (15.4) | ||
55- | 866 (30.2) | 245 (30.6) | 193 (28.9) | 275 (37.2) | 153 (23.3) | ||
Gender | |||||||
Male | 1,648 (57.5) | 472 (59.0) | 387 (57.8) | 411 (55.5) | 378 (57.5) | 0.966 | |
Female | 1,219 (42.5) | 328 (41.0) | 282 (42.2) | 329 (44.5) | 280 (42.6) | ||
Ethnicity | |||||||
Han | 2,832 (98.8) | 786 (98.2) | 660 (98.7) | 731 (98.8) | 655 (99.5) | 0.239 | |
Other | 35 (1.2) | 14 (1.8) | 9 (1.3) | 9 (1.2) | 3 (0.5) | ||
Education | |||||||
Elementary or lower | 315 (11.0) | 84 (10.5) | 89 (13.3) | 81 (11.0) | 61 (9.3) | 0.100 | |
Junior high school | 908 (31.7) | 252 (31.5) | 223 (33.3) | 278 (37.6) | 155 (23.6) | ||
High school | 702 (24.5) | 196 (24.5) | 155 (23.2) | 193 (26.1) | 158 (24.0) | ||
College and above | 942 (32.9) | 268 (33.5) | 202 (30.2) | 188 (25.4) | 284 (43.2) | ||
Marital status | |||||||
Never married | 444 (15.5) | 109 (13.6) | 122 (18.2) | 120 (16.2) | 93 (14.1) | 0.480 | |
Married | 2,294 (80.0) | 643 (80.4) | 518 (77.4) | 583 (78.8) | 550 (83.6) | ||
Divorced/Widowed | 129 (4.5) | 48 (6.0) | 29 (4.3) | 37 (5.0) | 15 (2.3) | ||
Occupation | |||||||
Managers and clerks | 220 (7.7) | 80 (10.0) | 53 (7.9) | 47 (6.4) | 40 (6.1) | 0.005 | |
Professionals | 199 (6.9) | 66 (8.3) | 37 (5.5) | 32 (4.3) | 64 (9.7) | ||
Commerce and service | 504 (17.6) | 129 (16.1) | 133 (19.9) | 121 (16.4) | 121 (18.4) | ||
Technical workers | 344 (12.0) | 68 (8.5) | 71 (10.6) | 68 (9.2) | 137 (20.8) | ||
Students or military | 322 (11.2) | 102 (12.8) | 56 (8.3) | 94 (12.7) | 70 (10.6) | ||
Operations | 225 (7.9) | 38 (4.8) | 74 (11.1) | 50 (6.8)) | 63 (9.6) | ||
Retired | 604 (21.1) | 170 (21.3) | 164 (24.5) | 199 (26.9) | 71 (10.8) | ||
Other | 449 (15.7) | 147 (18.4) | 81 (12.1) | 129 (17.4) | 92 (13.9) |
3. Data Analysis
4. Results
Outcome Variables | Time 1 | Time 2 | X2p * | |
---|---|---|---|---|
N X % | N X % | |||
Secondhand smoke (SHS) exposure | ||||
General | ||||
Hangzhou | 498 173 34.7 | 467 139 29.8 | 7.49 0.0578 | |
Jiaxing | 458 145 31.6 | 432 111 25.7 | ||
Healthcare facilities | ||||
Hangzhou | 566 172 30.4 | 381 97 25.5 | 25.43 <0.0001 | |
Jiaxing | 575 191 33.3 | 574 150 26.1 | ||
Schools | ||||
Hangzhou | 448 154 34.4 | 308 85 27.6 | 9.65 0.0218 | |
Jiaxing | 471 163 34.6 | 448 123 27.5 | ||
Government buildings | ||||
Hangzhou | 475 247 52.0 | 263 83 31.6 | 48.10 <0.0001 | |
Jiaxing | 483 273 56.5 | 419 175 41.8 | ||
Buses or taxis | ||||
Hangzhou | 739 232 31.4 | 583 101 17.3 | 14.72 <0.0021 | |
Jiaxing | 671 217 32.3 | 618 158 25.6 | ||
Restaurants | ||||
Hangzhou | 704 546 77.6 | 546 338 61.9 | 17.74 0.0005 | |
Jiaxing | 662 530 80.1 | 605 448 74.1 | ||
Smoking type and behavior | ||||
Daily smoking | ||||
Hangzhou | 800 197 24.6 | 669 158 23.6 | 0.55 0.9072 | |
Jiaxing | 740 198 26.6 | 658 158 24.6 | ||
Occasional smoking | ||||
Hangzhou | 800 105 13.1 | 669 44 6.6 | 11.44 0.0096 | |
Jiaxing | 740 83 11.2 | 658 68 10.3 | ||
Avoiding smoking near others | ||||
Hangzhou | 800 164 20.5 | 669 150 22.4 | 17.25 0.0005 | |
Jiaxing | 740 174 23.5 | 658 138 20.9 | ||
Avoiding smoking in public places | ||||
Hangzhou | 800 673 84.1 | 669 617 92.2 | 12.83 0.0050 | |
Jiaxing | 740 622 84.0 | 658 566 86.1 | ||
Belief in harm from SHS | ||||
Hangzhou | 800 726 90.8 | 669 621 92.8 | 19.28 0.037 | |
Jiaxing | 740 685 92.6 | 658 578 87.8 | ||
Awareness of harm from SHS | ||||
Hangzhou | 498 445 89.4 | 467 432 92.5 | 28.38 <0.0001 | |
Jiaxing | 459 423 92.2 | 432 402 93.1 | ||
Attitudes toward tobacco control | ||||
Banning smoking in public places | ||||
Hangzhou | 800 624 78.0 | 669 547 81.8 | 74.21 <0.0001 | |
Jiaxing | 740 594 80.3 | 658 563 85.6 | ||
Not smoking near women and children | ||||
Hangzhou | 800 698 87.3 | 669 600 91.2 | 73.45 <0.0001 | |
Jiaxing | 740 686 92.7 | 658 599 91.0 | ||
Tobacco control behavior | ||||
Quitting advice for family members | ||||
Hangzhou | 514 106 20.6 | 315 273 86.7 | 181.70 <0.0001 | |
Jiaxing | 532 160 30.1 | 422 96 22.8 | ||
Quitting advice for friends or relatives | ||||
Hangzhou | 713 621 87.1 | 599 467 78.0 | 27.86 <0.0001 | |
Jiaxing | 712 569 79.9 | 640 521 81.4 | ||
Household smoking restrictions | ||||
Hangzhou | 800 694 86.8 | 669 586 87.6 | 0.43 0.9348 | |
Jiaxing | 740 645 87.2 | 658 565 85.8 | ||
Workplace smoking restrictions | ||||
Hangzhou | 586 218 37.2 | 418 213 51.0 | 36.18 <0.0001 | |
Jiaxing | 585 195 33.3 | 589 406 68.9 |
Outcome Variables | Regulation Exposure | Time | |
---|---|---|---|
OR 95% CI | OR 95% CI | ||
Secondhand smoke exposure | |||
General exposure | 0.50 0.24 1.03 | 0.65 0.42 1.09 | |
Healthcare facilities | 1.40 0.98 2.02 | 0.71 * 0.53 0.96 | |
Schools | 1.33 0.96 1.85 | 0.68 * 0.48 0.97 | |
Government buildings | 1.72 ** 1.32 2.25 | 0.43 ** 0.33 0.56 | |
Buses or taxis | 1.26 * 1.05 1.49 | 0.56 ** 0.47 0.67 | |
Restaurants | 1.23 ** 1.09 2.03 | 0.45 ** 0.22 0.89 | |
Smoking type and behavior | |||
Daily smoking | 1.14 0.89 1.46 | 0.90 0.69 1.17 | |
Occasional smoking | 1.15 0.76 1.76 | 0.61 ** 0.42 0.90 | |
Avoiding smoking near others | 1.13 0.98 1.30 | 1.52 ** 1.17 1.98 | |
Avoiding smoking in public places | 1.30 0.97 1.74 | 1.23 * 1.06 1.42 | |
Belief in harm from SHS | 0.90 0.65 1.29 | 0.92 0.65 1.29 | |
Awareness of harm from SHS | 0.97 0.86 1.24 | 1.42 * 1.05 1.91 | |
Attitudes toward tobacco control | |||
Banning smoking in public places | 1.08 0.55 1.04 | 1.59 ** 1.17 2.18 | |
Smoking near women and children | 1.29 0.88 1.88 | 1.61 ** 1.13 2.19 | |
Tobacco control behavior | |||
Quitting advice for family members | 4.52 ** 2.39 8.52 | 5.88 ** 3.45 14.00 | |
Quitting advice for friends or relatives | 1.27 0.98 1.66 | 1.73 0.92 1.50 | |
Household smoking restrictions | 0.93 0.67 1.28 | 0.96 0.68 1.35 | |
Workplace smoking restrictions | 1.25 * 1.03 1.54 | 2.69 ** 2.10 3.46 |
5. Discussion
6. Conclusions
Acknowledgments
Competing of Interest
References
- WHO Report on the Global Tobacco Epidemic, 2011: Warning about the Dangers of Tobacco; World Health Organization: Geneva, Switzerland, 2011.
- Takala, J. Introductory Report: Decent Work—Safe Work. In Proceedings of XVIth World Congress on Safety and Health at Work, Vienna, Austria, 25–30 May 2002.
- The People’s Republic of China Ministry of Health. The 2007 China Tobacco Control Report; Ministry of Health: Beijing, China, 2007.
- Stillman, F.; Navas-Acien, A.; Ma, J.; Ma, S.; Avila-Tang, E.; Breysse, P.; Yang, G.; Samet, J. Second-hand tobacco smoke in public places in urban and rural China. Tobacco Control 2007, 16, 229–234. [Google Scholar] [CrossRef]
- Yang, T.; Xu, X.; Rockett, I.R.H.; Guo, W.; Zhou, H. Effects of household, workplace, and public place smoking restrictions on smoking cessation. Health Place 2011, 17, 954–960. [Google Scholar] [CrossRef]
- Making Cities Smoke-Free; World Health Organization: Geneva, Switzerland, 2012.
- Dawson, J.; Romo, J.; Mexico, D.F. Smoke-Free City Case Study. International Union against Tuberculosis and Lung Disease. Available online: www.theunion.org/news/mexico-city-smoke-free-case-study-launched.html (accessed 13 October 2010).
- US Department of Health and Human Services. Reducing Tobacco Use: A Report of the Surgeon General. Department of Health and Human Services; Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health: Atlanta, GA, USA, 2006. [Google Scholar]
- Sunstein, C.R. The social norms approach to preventing school and college age substance abuse: A handbook for educators, counselors, and clinicians. New Republic 2003, 228, 34–37. [Google Scholar]
- Gritz, E.R.; Prokhorov, A.V.; Hudmon, K.S.; Jones, M.M.; Rosenblum, C.; Chang, C.-C.; Chamberlain, R.; Taylor, W.C.; Johnston, D.; de Moor, C. Predictors of susceptibility to smoking and ever smoking: A longitudinal study in a triethnic sample of adolescents. Nicotine Tob. Res. 2003, 5, 493–506. [Google Scholar] [CrossRef]
- Yang, T. Tobacco Control. Theory and Implementation; People’s Health House: Beijing, China, 2010. [Google Scholar]
- WHO Framework Convention on Tobacco Control; World Health Organization: Geneva, Switzerland, 2003.
- Li, J.; Tu, Y.; Huang, Y. Review about tobacco control law in world and China. J. Public Health Prev. Med. 2010, 21, 71–75. [Google Scholar]
- Li, Q.; Hyland, A.; O’Connor, R.; Zhao, G.; Du, L.; Li, X.; Fong, G. Support for smoke-free policies among smokers and non-smokers in six cities in China: ITC China Survey. Tobacco Control 2010, 19. [Google Scholar] [CrossRef]
- Regulations on the Sanitary Administration of Public Places; Health Ministry of the People’s Republic of China: Beijing, China, 2011.
- Department of Comprehensive Statistics of National Bureau of Statistics. China Statistical Yearbook for Regional Economy 2008; China Statistics Press: Beijing, China, 2009.
- Smoke Free Regulation in Public Places in Hangzhou; Legislative Affairs Office of the State Council P. R. China: Beijing, China, 2010.
- Yang, T.; Abdullah, A.S.; Rockett, I.R.; Li, M.; Zhou, Y.; Ma, J.; Ji, H.; Zheng, J.; Zhang, Y.; Wang, L. Assessment of tobacco control advocacy behavioural capacity among students at schools of public health in China. Tob. Control 2011, 20, 20–25. [Google Scholar] [CrossRef]
- Yang, T.; Abdullah, A.S.; Rockett, I.R.H.; Li, M.; Zhou, Y.; Ma, J.; Zheng, Z.; Zhang, Y.; Wang, L. Tobacco advertising, environmental smoking bans, and smoking in Chinese urban areas. Drug Alcohol Depend. 2012, 124, 121–127. [Google Scholar] [CrossRef]
- Chinese Academy of Preventive Medicine. Smoking and Health in China: 1996 National Prevalence Survey of Smoking Patterns; Science and Technology Press: Beijing, China, 1997.
- Yang, T.; Rockett, I.R.H.; Wu, Y.; Chen, W.W.; Lu, Z. Agreement among multiple measures of self-reported smoking status in Chinese urban residents. Public Health 2010, 124, 437–443. [Google Scholar] [CrossRef]
- Ward, M.; Currie, L.M.; Kabir, Z.; Clancy, L. The efficacy of different models of smoke-free laws in reducing exposure to second-hand smoke: A multi-country comparison. Health Policy 2013, 110, 207–213. [Google Scholar] [CrossRef]
- Carpenter, C.; Sabina, P.; Casey, W. Public-place smoking laws and exposure to environmental tobacco smoke. Am. Econ. J. Econ. Policy 2011, 3, 35–61. [Google Scholar] [CrossRef]
- Abdullah, A.S.; Hua, F.; Xia, X.; Hurlburt, S.; Ng, P.; MacLeod, W.; Siegel, M.; Griffiths, S.; Zhang, Z. Second-hand smoke exposure and household smoking bans in Chinese families: A qualitative study. Health Soc. Care Community 2012, 20, 356–364. [Google Scholar] [CrossRef]
- Lin, Y.; Fraser, T. A review of smoke-free health care in mainland China. Int. J. Tuberc. Lung Dis. 2011, 15, 453–458. [Google Scholar] [CrossRef]
- Yang, T.; Fisher, K.J.; Li, F.; Danaher, B.G. Attitudes toward smoking cessation and triggers for relapse among Chinese male smokers. BMC Public Health 2006, 6, 65. [Google Scholar] [CrossRef]
- Rebagliato, M. Editorial: Validation of self-reported smoking. J. Epidemiol. Community Health 2002, 55, 163–164. [Google Scholar] [CrossRef]
- Wells, A.J.; English, P.B.; Posner, S.F.; Wagenknecht, L.; Perez-Stable, E.J. Misclassification rates for current smokers misclassified as non-smoker. Am. J. Public Health 1998, 88, 1503–1509. [Google Scholar] [CrossRef]
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Yang, T.; Abdullah, A.S.; Li, L.; Rockett, I.R.H.; Lin, Y.; Ying, J.; Guo, W.; Wu, D.; Li, M. Public Place Smoke-Free Regulations, Secondhand Smoke Exposure and Related Beliefs, Awareness, Attitudes, and Practices among Chinese Urban Residents. Int. J. Environ. Res. Public Health 2013, 10, 2370-2383. https://doi.org/10.3390/ijerph10062370
Yang T, Abdullah AS, Li L, Rockett IRH, Lin Y, Ying J, Guo W, Wu D, Li M. Public Place Smoke-Free Regulations, Secondhand Smoke Exposure and Related Beliefs, Awareness, Attitudes, and Practices among Chinese Urban Residents. International Journal of Environmental Research and Public Health. 2013; 10(6):2370-2383. https://doi.org/10.3390/ijerph10062370
Chicago/Turabian StyleYang, Tingzhong, Abu S. Abdullah, Li Li, Ian R. H. Rockett, Yan Lin, Jun Ying, Wei Guo, Dan Wu, and Mu Li. 2013. "Public Place Smoke-Free Regulations, Secondhand Smoke Exposure and Related Beliefs, Awareness, Attitudes, and Practices among Chinese Urban Residents" International Journal of Environmental Research and Public Health 10, no. 6: 2370-2383. https://doi.org/10.3390/ijerph10062370